Friday, May 17, 2013

My dog is licking his feet; boredom or health issue?

Yep, It has been a LONG time since I have written a post here.  Thought I would start back with a vet Q & A column-and if you have any questions you would like answered here-please just send me an email.  Here's the first one from a member of the training program my dog Alvy and I are in, Got Sit.

Dear DrReneigh,
I have a question. Just when I feel like we were having some great breakthroughs in training, Layla ruptured her CCL and has to be kept immobile for 2 weeks and then xrays will determine if she needs surgery or not. She has taken to licking her feet out of boredom; any suggestions on how to keep her occupied while she recovers?
I appreciate any expert advice you can offer.

Hi Debbie,
I am so sorry about Layla and her knee! My Alvy ruptured BOTH of her CCL's before she was 1 year old-you can imagine how much fun that was, trying to keep all that puppy energy calm and rested while she was recovering from 2 knee surgeries-ugh.
Most dog's do NOT
lick their feet simply from boredom.
Since this is the time when most dogs (and humans) are suffering from the worst allergies, I wouldn't be surprised if Layla is licking her feet because of some allergy issues, or maybe because they are itchy for some other reason like a yeast infection. Be sure to have your veterinarian do a good examination of her feet before just assuming it is a behavioral (boredom) issue-sometimes antifungal sprays for yeast infections or treatment for allergies are the way to go.
If it is truly a boredom issue, and we can't run the heck out of her to get all that pent up energy worked out of her, then unfortunately we may have to resort to using the e-collar or cone of shame until this period of confinement is over.  Kong toys stuffed with goodies  or other toys to keep your pet occupied can be helpful.  Tranquilizing or sedating medications may be helpful, as may products like DAP collars (pheremones) or "Thundershirts" to decrease anxiety.
Good luck with Layla. Don't worry, Marvin and the Got Sit classes will be waiting for you both when she is all recovered-Alvy and I are good examples of that!
Let me know if you have any further questions or need any help with her.

Monday, November 8, 2010

Moving On

This post won't have much to do with veterinary "stuff," but it does have to do with that incredible connection some of us have been fortunate to share with a very special animal in our lives. It is just personal ramblings-so won't be for every one.

Many of you know I lost my best friend, Verbal, earlier this summer-on Father's Day in fact. I never knew a heart could break like that. I have been so lucky to have good, understanding humans in my life to help me through the loss, but ultimately it has been just a terribly lonely and painful ordeal. Any one who has lost a "heart" dog or cat (or horse or rabbit for that matter) can relate to some of what I went through, and many people have been helpful in relating their experiences. Some told me of dreams or visions they had of their beloved departed pet-and how comforting that was for them. The dream was a way for that pet to "communicate" to their human, to let them know they were doing well, moving on, watching over them, or whatever the message was that they felt their owner needed to receive at the time. Regardless, it was almost always a means of closure, and I was so envious of that!

As time passed, I kept wondering why in the world I wouldn't dream of my dear Verbal dog. We had shared so much in this life, had been so very close, and I began to worry that maybe she WASN'T in a peaceful place, watching over me, maybe she was scared, alone, couldn't "move forward," that I had left things unresolved-you know how a grieving mind can work. I know my husband hurt, too, but he was getting on with life, and he didn't know what to do with me when I was crying my heart out every night. After a month of that, just exhausted from the pain, I did what I thought I "should" do-I got a puppy.

I visited only two puppy "brokers," and that is exactly what they were. The first was a true puppy mill, no matter how nice things might have seemed on the surface, and I couldn't in good conscience support that "business." The second was an actual rescue situation-adult dogs being bred well past "retirement" ages. There were 10 and 12 year old momma dogs with mammary tumors, flea and worm infestations and who knows what else-and I don't think any one could really match up which parents went with which puppies. Selling puppies would help the rescue group get the older dogs spayed and neutered and re-homed. I wished I could have stepped up and taken an older dog, but after just losing one old dog, I knew my heart wasn't in any kind of shape for that. I used my check book to help with what I could, and scooped up a mangy, pot-bellied skinny yellow puppy, was handed a bag of "Atta Boy" dog chow to tide her over ( give me a break,) and headed home.

I texted a picture of her to Michael on the way home. I just got the reply "It's a puppyyyyyyy!!!!" so figured that was an approval of sorts. It really didn't matter much-it was love at first site.

I'll fill you in later on the antics of "Alvy" and her wily ways of working her way into our lives...and hearts over the past few months. Suffice it to say, she has grown from a scrawny 10 pound 9 week-old babe to a pretty robust 6 month-old DOG now.

This past Saturday was a pretty terrific day all around. I soooo wanted to sleep in on that rainy morning, but made myself get up early so I could take Alvy to her training class. We are in a program called Sit Means Sit, and I can't say enough about how well she and her class mates are doing with their training. I should say "our" training-probably 80% or more of dog training is training the humans, and I am definitely in that category. We all meet in "real world" situations-parks and schools-so face all the distractions that are inevitable. It is amazing to see even very young puppies focusing on their humans, intent on figuring out the puzzles and wanting so very much to please. They have such a great time in the classes-lots of work, but lots of breaks to run around and play with classmates or tug on a toy, fetch a frisbee or yes, jump in puddles or whatever. I will certainly write more about this amazing training system-I'm a big fan, not only because of how well Alvy and I are doing, (she was "spotlight client of the month" in November-check out her Bio on their site) but also because so many of my clients and patients have taken part in it and some have begun solving even some major problems like aggression.

After class, Michael and I decided to take Alvy over to a dog park I read about on Whidbey Island. Now, we have plenty of dog parks around here-so why take a ferry ride? Well, the weather has a tendency to be a little better over on the Island, and this dog park just happens to be on a BEACH! Oh boy! Alvy had never been to a beach, and I was very excited to introduce her to all that meant. It was a great choice. The dogs were allowed to be off leash while on the beach itself, so Alvy could run play and body slam with all the other dogs-and of course, find all the dead stinky things to roll in, waves to jump in, and salt water to lap up (before she figured out that wasn't such a great idea!) We must have played for 2 hours-I thought I'd have to carry her back to the car, but she made it just in time to collapse on the pile of towels I actually remembered to bring. She was so darned happy! It did my heart good to give her this gift. I know we have other beaches pretty close, and this one really wasn't far at all-we will be doing the beach thing a LOT!

You can imagine we all slept very well that night. I had actually been pretty sick for several months and was finally starting to breathe better and sleep through an entire night without waking up in fits of coughing. And guess what happened that night? I dreamed about my dear sweet Verbal dog! It wasn't anything earth shattering or unusual-she didn't talk to me or anything like that. She was just comfortably walking by my side as she always did-and now I knew she always would-my old friend was there by my side, or rather, we were together, by each others sides-forever.

I know that after 5 months of wishing and hoping for a "sign" from her, my dear Verbal came to see me after we gave Alvy a perfect day-and she told me that was as it should be. Life goes on. The young whipper-snapper deserves all the love we have to give her (and all the stinky dead things to roll in!) Verbal was telling me that Alvy was lucky to have come in to our family-she would always know love and care (and fun!) but we are lucky to have her in our lives, too. Verbal would have hated having the youngster around her-it is why we never did have other dogs while we had Verbal. Young puppies were big ol' pains, disrespectful of older dogs who might be hurting like Verbal did. Despite this, Verbal was acknowledging that her humans' happiness was the most important thing to her-and if this obnoxious puppy could give us that happiness, that was as it should be. And by the way, she (Verbal) wasn't going anywhere. She would be right by my side as that puppy frolicked ahead. Moving on certainly doesn't mean replacing or forgetting.

Oh my. I have never been more relieved (or more happy) to have dreamed such a simple thing. It only took 5 months of wishing and hoping and praying...

A few hours later I was in church...and realized it was All Saints Day. We lit candles in memory of family or friends who died this past year. You can bet I lit a candle for Verbal. She was family. She was my friend. There was no one who better fit the qualifications. A friend sent me the link to this very sweet song/poem about dogs and God-check it out if you have the time. God and Dog

I have had quite a few friends and clients ask me when I might start to blog again. I don't know if I can keep up the momentum, but telling this story of Verbal's dream visit seemed worthy of an entry, maybe the start of something regular. But regardless, it is a pretty good story, isn't it?


Friday, February 5, 2010

That's a Mouth Full!

This week one of my tiniest, sweetest little patients was diagnosed with a problem that is quite a mouth full to pronounce: crycopharyngeal achalasia. Whew! It made me think back-WAY back-to my first medical terminology class. I took it as an undergraduate student at Cal Poly in San Luis Obispo. I liked it because it wasn't a course where you had to memorize lists and lists of those mile-long, foreign words. Instead, we were taught how to break down those words in their prefixes, suffixes, roots and parts-dissecting them if you will- and this way found we actually knew the meaning of most of those daunting words, even if we had never heard each one before.

We started with the basic terms we learned in our anatomy classes, words describing parts of the body, organs, etc. Derm refers to the skin, osteo to bone, cerebral to the brain, cephal is the head, coreo is the pupil of the eye, and cardio the heart. Cysto refers to a bladder, renal or nephro to the kidneys and hepatic to the liver. Chol refers to bile or the gall bladder. Ovo refers to the ovaries while orch refers to the testes. I wasn't amused when we learned that the root for uterus was "hystero" because females were considered "hysterical" by their doctors. Wonderful. Metra can also refer to the uterus.

We then learned the prefixes that describe these organs or conditions. "A-" can simply mean without or not. "Neo-" is new or recent. "Bi-" means two or double. "Iso-" means equal or alike. "Endo-" means within. "Pyo-" refers to purulence or pus.

Suffixes might further describe or quantify conditions or situations. "-algia" refers to pain or a painful situation. "-itis" refers to inflammation. "-osis" simply refers to "the disease or condition of." "-lith" refers to a calculus or stone. "-otomy" means to surgically cut into while "-ectomy" means to surgically remove and "-ostomy" means to crate a permanent hole in. "-oma" usually refers to a benign tumor while "sarcoma" refers to their malignant counterparts.

So, let's try out your new skills in medical terminology. Break down the big words into their smaller, more familiar parts and see what you come up with. You will be surprised how easy (and even how fun) it can be!

1) Dermatitis
2) Nephrectomy
3) Pyometra
4) Endocardiosis
5) Cholecystolith
6) Ovariohysterectomy
7) Osteosarcoma
8) Acholiosis
9) Tracheostomy
10) Isocoria

Ok, here are the answers-I'm sure you got all of them right!

1) Derm-skin + itis-inflammation = inflammation of the skin
2) Nephro-kidney + ectomy- surgically remove = to surgically remove the kidney
3) Pyo -pus + metra- uterus = pus in the uterus or a uterine infection
4) Endo-within + card-heart + osis-condition or pathology of = disease inside the heart, actually refers to a disease of the heart valves (which are inside the heart-see how this works?)
5) Chol-bile/gall + cysto-bladder + lith-stone = gall bladder stones
6) Ovario-ovaries + hyster-uterus + ectomy = removal of the uterus and ovaries-in dogs or cats, we call this a spay surgery.
7) Osteo-bone + sarcoma-malignant tumor = bone cancer
8) This one looks hard, but just break it down...a-with out + chol-bile + osis-condition of = the condition of not being able to produce bile.
9) Trache-refers to the trachea + ostomy-to create a permanent hole in = creation of an opening into the trachea.
10) Iso-the same + coria-refering to the pupils of the eye = having pupils that are the same size.

Look at that! I knew you could do it. See? Doctors really aren't all that smart. Using big words just makes them sound that way, and now you know the secret behind doing that, too. And it doesn't even give you cephalgia (a headache) to use those big words, too.


Tuesday, January 26, 2010

No Puppies for Heike

Heiki wasn't feeling quite herself. Normally vivacious, full of life and energy, the first day we saw this wonderful Coton de Tulear, she was a little down. She was fortunate to be owned by a very observant lady who noticed early on when something wasn't quite right and brought her in for an exam. She noticed that her appetite was off the past two days or so, and most significantly, Heike had some clear, shiny discharge from her vulva which she kept trying to lick clean. Her temperature was a bit elevated, too. Heiki's owner also happened to be her breeder-and was very knowledgeable that these symptoms could be signs of trouble with the reproductive tract. She told me that Heike had been bred 3 weeks earlier.

By far, most breedings of dogs happen with no problems at all. But the process isn't exactly sterile, and bacteria can get introduced into the reproductive tract of the female dog during mating. They will migrate up through the cervix, which is relaxed during estrus instead of being closed tightly as it is during the rest of a dog's cycle. The bacteria then start to reproduce in the uterus, creating an infection here we call a pyometra-literally "pus in the uterus."

We can see two types of "pyos," open and closed. These descriptions refer to the cervix, and tell us if the infection is trapped or contained in the uterus creating a life-threatening "balloon" of infected material or if the bacteria and pus is able to drain or leak out of the uterus through the cervix. Both are incredibly serious problems for any dog, much less a breeding female.

Now, the discharge coming from Heike's reproductive tract at this point didn't look like pus-it was clear with no blood or other cells in it at this point. We decided to do an ultrasound exam of her uterus and see just what was going on in there. We shaved some of her glorious long white hair from her abdomen and very quickly confirmed that Heike was, indeed, pregnant. This certainly made our treatment decision more difficult-if it was at all safe to do so, we would like to be able to continue the pregnancy. Since we suspected the discharge could be normal or could be early signs of the pyometra infection we were concerned about, we talked at length with Heike's owner. Another possibility was that the pregnancy was trying to resorb or abort for some reason. We trusted that Heike had the type of owner who could carefully monitor her condition, give medication as directed and watch for the changes we discussed. If Heike stopped eating or started vomiting we wanted her right back in. If her temperature increased, or if the vulvar discharge turned milky or creamy we needed to recheck her. Many dogs with pyometra will start to drink water excessively, so we wanted to watch for this, too. Since we knew she was pregnant, monitoring for a distended abdomen wasn't going to be very helpful. But if she became painful in her belly, that would be a bad sign. We gave Heike a prescription of an antibiotic we felt would be effective for an infection in the uterus but would also be safe for developing puppies, gave her some fluids under the skin to help her hydration and slight fever, and sent her home.

Heike's owner was diligent in medicating her and giving her fluids, orally and subcutaneously. She monitored her vital signs as we asked, and Heike did pretty well for about a week. About that time her temperature actually decreased to below normal and she stopped having any vulvar discharge. We had her come in to reevaluate, and did some blood work and another ultrasound exam. The blood work showed a significant elevation of her white blood cells, a tell-tale sign of infection in the body despite the week-long antibiotic treatment. The ultrasound exam showed that the pregnancy was not progressing as expected. In fact, while we could see the individual vesicles of amniotic fluids, no evidence of feti were found in those vesicles. The uterus itself was very large and fluid filled. With no vulvar discharge seen now, we diagnosed a closed pyometra.

As mentioned before, a closed pyometra is a life-threatening condition. As the uterus fills with pus, the wall of the organ becomes stretched thin and attacked from within by the bacteria, weakening the tissues and making rupture of the organ very possible. The only treatment is an emergency removal of the uterus, hopefully before any rupture or leakage of any amount occurs. We rearranged our schedule and got her right into surgery. It was a good thing we didn't wait.

Normally a thin band of tissue, sometimes even difficult to find among all the intestines and other abdominal contents, Heike's uterus was huge, bulging up right under the incision I made in her abdominal wall. I exteriorized it carefully, revealing the "balloons" we saw on the ultrasound exam.
While thinning in some areas and obviously very diseased tissue, there were thankfully no obvious tears, ruptures or leaking areas. Gentle handling was essential to keep that from happening. I wanted to remove the entire pus-filled uterus, along with both ovaries and the supporting tissues without spilling the contents into the surgical site. Unlike in a human female where the uterus has a simple body, (just fine for a single fetus) the uterus in a dog consists of two "horns," much better suited to accommodate the numerous developing puppies or litter. You can see Heike's diseased uterus kind of looked like big sausages-very abnormal.

We were able to remove both of Heike's uterine horns and ovaries without obvious pus contamination of the abdomen, but we flushed out her abdomen with warmed, sterile saline as a precaution, explored the rest of her abdominal organs briefly and found no other problems, and closed her incision. After we removed the diseased organ from her body, we opened it up and found that, sure enough, it was filled with a huge volume of a nasty, strawberry milkshake colored liquid that anyone could tell wasn't normal. The entire surgery was less than 30 minutes, but without it, this sweet little dog would certainly have died from that infection.

It is tempting to treat these dogs like those we have spayed-just a "routine" procedure, especially when they do as well as Heike did. But that would be a mistake, and could have resulted in a decline in her condition later. There was nothing routine about needing to rush to surgery right away. Heike had no time for adequate preparation before surgery, such as fasting, and she was only started on her IV fluids minutes before I made the incision into her abdomen. That uterus was hardly normal, and her blood work showed an obvious affect on her entire body from sepsis or pronounced infection. Her lower than normal body temperature was a sign that her body could no longer handle things on its own and might be facing impending shock. Heike was placed on a different, more powerful antibiotic, one we couldn't use earlier when we had a potential pregnancy to consider. She had aggressive IV fluid therapy and her nurses got her body temperature back up to normal-and kept it there. Her surgical pain was managed well with narcotics before and after surgery, as well as a non-steroidal anti-inflammatory medication. She was also sent home with an appetite stimulant, as getting her to eat right away would be very important to her healing process.

Heike was fortunate that her owner knew the signs of pyometra and how serious it could be. Even if an owner didn't know about this disease specifically, just knowing the "normals" for your pet, his or her normal habits, appetite, activity level, etc. really goes a long way to helping know when something just isn't right. It is the veterinary team's job to then try and figure out why that is-working as a team, we got Heike all fixed up, sent her home to her owner and when we later rechecked her, found that she was the happy, healthy dog she had always been.

But even happy and healthy isn't enough if you are a female dog living with a breeder-and you don't happen to have a uterus! Heike needed to find a new home, and that she did. She actually got to make a plane trip across the country, and now lives with another sweet "cotton" dog, MC. Heike is now known as Olivia-and she couldn't be happier! Her new owner opened her home and heart to this sweet little girl. We are glad that everything has worked out so well for everyone. Good luck, sweet Olivia!


Monday, November 30, 2009

Lucy is #100!!

Lucy was normally a feisty and trouble-making tortiose shell kitten. Well, yesterday she had the trouble-maker part down pat. Her feisty personality was toned way down, though. She had vomited the day before, a piece of what looked like gift-wrapping ribbon. And there was blood in the vomitus. If that had been all, and she had gone back to eating and tormenting her brother and all, well, that would have been that. But Lucy's mom just had a feeling about her, and I have learned never to dismiss a mother's intuition. She brought her in first thing in the morning-and I am glad she did. Lucy's usual glossy hair coat was oily and rough-she wasn't grooming herself. Her gums were tacky and dry-she was dehydrated. And when I palpated or felt her abdomen, she became very tense and painful-different from the normal-"don't do that, I don't like it" reaction most cats will give me. It might be a subtle difference, but like her mom, I knew it when I saw it.

Because of her history of vomiting up what looked like ribbon, we decided to take some radiographs of her abdomen right away. Now, for most patients with a little vomiting or gi upset, I don't usually jump right to x-rays. They are expensive, and by far most pets are going to get better with a little tender loving care, maybe a fast, some fluids, bland food, etc. But remember her mother's intuition? And remember her painful abdomen? And remember she vomited blood and ribbon? Those symptoms all added up to trouble-and I wanted to be ahead of the game with Lucy's diagnosis. I'm glad we took the pictures.

Lucy's radiographs showed a whole lot of "stuff" in her stomach-lots of very distinct lines all packed together-nothing readily identifiable. Her owner said she hadn't been fed since the night before, (and she didn't know if she ate then or not-she does have another kitten in the household.) Lucy hadn't had any breakfast, so she shouldn't have had anything in her stomach at that time. Since I couldn't identify just what it was, but knew it shouldn't be there, and because that meant a pretty big next step-surgery-I wanted a second opinion on the films.

We have all of our x-rays read by a board certified radiologist-I learn a lot from him and it is a lot of comfort to have that second set of eyes when I'm just not sure of what I'm seeing. Our local veterinary reference laboratory provides a courier service for the films themselves, (I haven't made the 70+ thousand dollar investment in a digital system yet...) picking them up and delivering them to the radiologist's office where he interprets the films, faxes us a copy of his results, and sends the films back via the same courier service. This is a very handy and speedy service, but still takes a day or two at best. We can occasionally arrange for "stat" pick up and delivery of films, but there is a considerable extra fee involved, and still some delay. Since I was worried about the liklihood of imminent surgery for little Lucy, I asked her owner to hand carry the films to the radiologist's office herself, saving the fee and resulting in much faster results. Lucy stayed with us, and so did George, her big brother-more for moral support for HIM. He couldn't bear being seperated from her!

All this worked out very well. In about an hour the radiologist gave me a call and concurred: the radiograph findings suggested we should do a "peek and shriek" surgery. In proper medical terms, an exploratory laparotomy. I like "peek and shriek" just fine. They are usually quick and we usually find some pretty impressive things to "shriek" about in these surgeries-and Lucy's was no exception.

We called Lucy's mom and told her what she was already suspecting-Lucy would be going to surgery right away. We called a few other owners to rearrange the schedule-those with "routine" appointments for things like vaccinations had no problem resceduling for another day. Others with ill pets, just not as critical, got moved to a little later-all knew that if it were their pet needing the emergency attention, they would be first in line. That's just how we do things here, and everyone is usually very understanding.

I have to mention here how very lucky Lucy is to be owned by such good humans. Not only did they recognize her signs of illness and bring her right in, they also accepted the responsibility and need to care for her, making big sacrifices during this holiday season so they could provide the care she required. We all know that isn't the case with all of our animal friends, especially in these difficult economic times. Hurray for Lucy's humans!!!

Schedules were rearranged, the staff swallowed some pizza I got for their lunch and off we went to surgery. Lucy did great, and so did her team. She was anesthetized and prepped for surgery, and I was in the surgery room with her in record time. It didn't take long to find her problem. Her stomach was the size of my fist, (That's pretty darned big for a 9 pound cat!) and although outwardly it looked just fine (no signs of perforations or necrosis, thank goodness) it was rock hard. I ran through the rest of the gastrointestinal tract and found it was completely empty-whatever was in the stomach had prevented anything from entering her intestines for quite some time.

After ensuring that the stomach was the sole problem area, I performed a gastrotomy-an incison into the stomach wall.
The contents were pretty impressive-wads of what appeared to be plastic strips and elastic bands-hair bands and maybe even a small bungee cord. And yes, there were many pieces of colorful ribbons, too. Lucy had been collecting these goodies for quite some time.

We saved all these treasures to show her owners-after all, they were paying good money for retrieving them! Hopefully they would be able to identify them-and then be able to "Lucy-proof" their home a little better than they thought they were. Her incisions were closed up, Lucy was given some good pain medication, and she was tucked into her recovery kennel, nice and toasty warm. She was a bit slow to wake up, but there was no rush. We monitored her carefully, and by the end of the day, she was doing just fine. She even ate a couple fingers full of food! We set up some nurse checks and I put my web cam on her so I could monitor remotely. She got a little over heated with all the heat lamps, heated kennel and heated rice bags, so those were removed during the night, but otherwise, everything went smoothly. Lucy had another dose of pain medication this morning, and soon after she began eating like a pig! She wouldn't let poor George any where near the food dishes. She must have been starving for actual real food-hair bands don't have much nutritional value.

Lucy's owners came this morning to pick up her and her brother-the house must have been awfully quiet without those two last night. We went over her care instructions-I don't usually consider gastrotomy patients "out of the woods" until about 10 days or so post-op. That would give the stomach incision plenty of time to heal and digestion to start up again. If any leakages were to occur, infection would become obvious during this time. All in all, I was quite pleased with how she did, and expect her to recover just fine. Now it is up to her humans to keep her away from those darn enticing stringy things. My own cat, Stella, has an addiction to curly ribbon-she can just smell a package wrapped with the stuff when it enters the house and is immediately drawn to it, chewing frantically unless I intervene. It is weird just how much certain cats love to chew on things like this-ribbon, string, yarn, tinsel, dental floss, and yes, hair ties. If you don't know what your cat's predilection is for these things, don't take a chance! Keep them in drawers or cabinets or in covered bins. Surgery is no fun for any one. (Well, I actually DO like these types of surgeries :) "A chance to cut is a chance to cure." In Lucy's case this adage is particularly true.

Wow! Lucy's story makes 100 blog entries! That is quite a milestone, especially since I took the last 3 months or so off. I hope you have had some fun reading about the various patients that have come and gone in our busy little hospital-maybe were grossed out by a few stories, laughed at some, shed a tear or two at others. I tried to always add a little "educational" aspect to most of my blogs-hopefully teaching fellow pet lovers some new things about their friends, reminding you of situations to be aware of or just exposing you to an aspect of veterinary medicine that you might never have considered before. Some veterinarians are called upon to do some pretty amazing things-from realigning the broken bones in the leg of a puppy accidentally stepped on by the playing children, to stuffing the intestines of a "broken" spider back in his body and super-gluing him closed. Some of us who enjoy surgery might get to repair a torn ACL on a rambunctious lab or pull hair ties out of a kittens packed stomach. We occasionally get to diagnose rare or exotic illnesses, and the outcomes may not be good-but hopefully we learn from them, too. With all this knowledge and technology at our hands, we still have a "few" limitations. (Ha ha! I wish it were ONLY a few!) But I was referring in this instance to a limitation I have often wished we didn't have-we still aren't capable of installing zippers into the bellies of patients who repeatedly eat things they shouldn't eat.


Thursday, August 27, 2009

A Big Dog With a Big Problem

Kodi was a BIG dog-a gorgeous 120-pound Malamute- who had a very big problem-his kidneys weren't working like they should. For him, this meant the waste products of every day metabolism that build up in the bloodstream just kept rising, unable to be filtered by those failing kidneys. Now, Kodi wasn't an old dog as you would have expected. Older patients get things like organ failures-they just wear out after years and years of use. Sometimes they get cancer in those organs. This just wasn't the case for Kodi-he was only 4 years old. As we attempted to treat Kodi for the obvious problems resulting from his kidneys not working, we also had to go on a hunt for possible causes of their failure-or we might not be able to stop it from happening again.

Since kidneys are a filtering organ, anything that travels in the blood stream and accumulates in the kidneys could potentially casue those organs problems. Drugs like non-steroidal anti-inflammatory medications can do this, especially ibuprofen, a drug really meant for human, NOT canine use. Other medications humans routinely take could have renal toxicity problems in dogs, but Kodi's owners were fairly certain he didn't have access to anything like that. They hadn't given him anything as some people do, "just to make them feel better" before resorting to a veterinary visit. We couldn't think of any plants or yard products/chemicals he could have eaten, and they hadn't changed their anti-freeze in their cars recently. Anti-freeze is a well known kidney toxin.

There are, of course, primary diseases of the kidneys themselves-infections like pyelonephritis which can develop from bacteria that travels up the urinary tract from the bladder to the kidneys when a pet has a bladder infection, often unnoticed by owners. The blood work we did on Kodi did not indicate any infection in his body right then, but it was still a slight possibility.

Leptospirosis is a bacterial disease that can affect the kidneys of dogs, as well as humans. Wild critters such as possums, racoons and rats can be the carriers, spreading the organism through their infected urine. The disease can be serious for both humans and animals. In people, the symptoms are often like the flu, but sometimes leptospirosis can develop into a more severe, life-threatening illness with infections in the kidney, liver, brain, lung, and heart. Because we had put many of the other possibilities for Kodi's kidney problems lower on the differential or "rule-out" list, leptospirosis worked its way higher up the list. Testing for the disease is done via a blood sample, but results often take 10 days to get back. Since the treatment for the leptospirosis bacteria itself is done with antibiotics, we decided to start Kodi on these right away rather than wait for the test results to come in.

Leptospirosis is one of the "big" diseases we usually vaccinate at-risk dogs for every year, but unfortunately the vaccine does not provide 100% protection. This is because there are many strains (types) of this bacteria, and the vaccine does not provide immunity against all strains. It is important to get your pet vaccinated again even if it gets leptospirosis because it can still get infected with a different strain of leptospirosis. Kodi was vaccinated each year for 4 different strains of lepto, but his test came back positive for another strain, one for which a vaccine is not available. It was a good thing we had started him on antibiotics when we did. when we got the test results back, we also started his house mate, Kiona, on a prophylactic course of antibiotics. She wasn't showing any symptoms of the disease, and we certainly wanted to keep it that way.

As mentioned, treatment for the leptospirosis bacterial infection is antibiotics, specifically those in the penicillin family. These will arrest the on-going infection, but dogs can remain carriers of the disease unless a second antibiotic from the tetracycline family is used, often for 6 weeks, to break that carrier state. Kodi was initially put on injectable ampicillin since he was so nauseated and anorectic from the kidney disease that resulted from the infection. And this was the big problem: we had a handle on the disease and could get it treated, no problem. But the damage it had already done to Kodi's kidneys was severe-he was hospitalized multiple times, once for 4 days in a row for 24 hour a day IV fluid therapy in a attempt to diurese his blood and get those kidneys working again. It never worked. His owners were terrific. They did everything we asked of them, bringing him in for testing, for hospitalization and treatment despite the considerable time they had to take off work and expenses they incurred. He spent a lot of time with us and in the emergency hospital when we weren't available.

We really expected such a young, big, strong, dog to turn the corner any time and make a full recovery, but it was not to be. Kodi's initial bloodwork showed just how poorly the kidneys were doing, and his first retesting of their values showed good improvement. Kodi was given very aggressive care, including those antibiotics, fluids, anti-vomiting medications, prescription renal diets to require less work on the kidneys while providing good nutrition for healing, antacids, appetite stimulants, phosphate binders (phosphorus levels go sky-high in kidney failure patients, making these patients very weak and wobbly, and Kodi was no exception)-you name a drug in our pharmacy and he probably was on it at one time or another! Subsequent testing showed no changes in those kidney values, and his phosphorus levels worsened, making him even weaker. His owners were reaching their limits of what they wanted to put him through, and frankly, what they could afford to spend. When Kodi finally became painful-his kidneys evidently swollen and tender-he was crying out as only a 120-pound Malamute can-his loving owners made the choice to end his suffering and said goodbye. It was a terrible tradgedy-his owners did everything right, loved him, fed him right, provided him with good preventive health care-and it just wasn't enough. They unselfishly did the right thing for him that weekend, as hard as it was on everyone involved.

Kiona is still symptom-free, and we fully expect her to stay that way. We had a little scare when one of out veterinary technicians became ill this week and made sure to alert her physician about her exposure to leptospirosis. In fact, we were required to report Kodi's case to the state veterinarian, that's how serious this disease is.

Definitely get your pet vaccinated for leptospirosis (the "L" part of a typical DHLPP vaccine) if he or she is at risk, and do your best to control the rodent/small animal population to minimize their urine in your pet's environment. Leptospirosis is out there, but is not a very common disease, thank goodness. If your pet has been confirmed by your veterinarian as having leptospirosis, don't despair. Early, aggressive treatment usually brings about good results. Kodi's case was rare and tragic.


Monday, August 10, 2009

Making Herself Right at Home

So, the picture is a little blurry, but that is because little miss Raena was moving pretty darned fast. That big silver disc she is on is actually her exercise wheel, a pretty great design, considering most of the ones you usually see for rodents are made of open wire, and an open wire wheel caused Raena a huge problem a few years ago. She got hung up in it somehow (she wasn't telling exactly what happened) and broke her tiny little leg. We tried to fix it, but rodents aren't known for being the best patients when it comes to injuries like that, and Raena the chinchilla was no exception. Chewing at wounds and suture lines, and not understanding the meaning of "rest" or "taking it easy" until the bone could heal meant numerous complications, and she ended up having her left hind leg amputated. Not that you would ever know that today. She may have a goofy little swing to her gait, but when she gets going on her nice solid wheel, she looks like a pro! And boy, is she fast! We had her out in the living room the other night just to see her scamper around. When it was time to put her to bed-ha! it was crazy trying to catch that slippery little varmint! It really does my heart good to see how lively she is-don't even dare consider this girl "handicapped." A 3-legged chinchilla is just the most natural thing in the world, at least it is in a vet's home!

My husband Michael and I lost our first chinchilla, Edgar, last year. He was over 15 years old-quite a distinguished old man, and such a wonderful little pet. I don't think we realized just how much we had missed him until we learned that Raena's owner was asking about finding her another home. My hospital manager, Cori, had owned one of Raena's babies at one time, and she would have made a great home for her. But she has a very happy chinchilla already, and she didn't want to risk upsetting the balance of his life by adding another critter right now. I jumped at the chance to add Raena to our little family, and she came home with me last Friday.

You would think she would take some getting used to her new situation, needing some time to figure things out and all but, no, not Raena. She never missed a beat, jumping out of her travel carrier right onto her exercise wheel and going for a short run right when she arrived. Then she hopped over to the side of the cage and took a raisin from Michael-he was thrilled! It was one of Edgar's favorite treats, and now you can be sure she will be spoiled rotten by her new "dad." Raena wasn't even phased by the cats who came running over to see who was taking occupancy of the great big cage in the living room-they were pretty perturbed it wasn't for them! Anyway, Raena didn't even bat an eye at those natural predators, or maybe she was batting her eyes, winking and flirting, more like teasing those cats who are easily 6 or 7 times her weight!

Chinchillas are members of the rodent family, actually closely related to porcupines if you can believe that!, but also related to guinea pigs.

Yes, chinchillas were originally bred in captivity for their pelts-it IS wonderfully luxurious and beautiful, but it seems to me it would take an awful lot of those little guys to make a single coat! Current fur colors we see include white, silver, beige, and black. The chinchillas who were lucky enough to have lower quality fur were sold as pets, although some were used as research animals. That is how I got my first chinchilla, Edgar-he was losing all of the fur on his body, not exactly what they wanted in the fur-coat business, thank goodness! He was a wiley little dude-he grew a gorgeous thick silver coat after he came to live at our home and was no longer at risk of being made into a coat.

Chinchillas originated in the barren, mountainous regions of Peru, Bolivia, Chile and Argentina-particularly in the high altitude Andes mountains. The first known chinchilla ranch was founded in Chile in 1874 in Vallenar by John Murry, an English member of the famous scientific expedition "Challenger." In February 1923 an American mining engineer, Mathias Chapman, brought the chins to North America. He was in charge of several mines in the Andes and that is where he was introduced to the chinchilla. He took an immediate liking to the little guys and hoped that he could take a few of them home to California as pets. The export of chinchillas was illegal, however, he eventually persuaded the authorities to permit him to take eleven chins with him back to the States. Eight male and three female Chinchilla Lanigeras. He brought them down from the mountains and arranged passage on a Japanese freighter. And the story goes, (although this is almost certainly apocryphal) that all the chins in North America are descended from Chapman's.

In general, chinchillas are very friendly and clean little pets, and compared to most pet rodents, have very little odor. They can be quite shy and high-strung and therefore easily frightened, so they aren't the best pets for small children. It can be difficult to house multiple chinchillas in one cage, even in larger cages, especially if you have a more aggressive female chinchilla. Breeders and pelters have an interesting arrangement for their habitats to avoid "disagreements." They will create polygamous colonies with one male having access to five or so females maintained in separate cages. The male has a tunnel along the back of the females' cages which enables him to enter any cage at will. The females cannot pass through the tunnel because they are fitted with light-weight collars that are just a little wider than the cage opening.

Chinchillas are best housed in large, wire-meshed cages for proper ventilation, with or without a solid floor. They need some sort of enclosed nesting box to sleep in. They tend to be nocturnal creatures, spending a lot of time running around, eating and playing while YOU are sleeping-so be sure to oil that squeaky exercise wheel! Wood cages aren't a good idea because chinchillas are constant chewers, and pretty quickly your nice wooden cage will be a pile of saw dust! Ideal environmental temperatures are around 60 to 75 degrees F.

Raena has been fed a very good, balanced diet-but that isn't the case for a lot of the pet chinchillas we see. In fact, improper nutrition and/or husbandry (housing and care) are the most common causes of health problems in our little rodent and other small pets. She gets a pelletted chinchilla diet, although not all pet stores or feed stores will carry this. Using a standard rabbit or guinea pig ration is OK temporarily. Chinchillas like Raena are really cute when they eat, tending to pick up each pellet with their little hands, but they can be pretty messy, too, throwing a lot of pellets around the cage, so there can be quite a lot of waste. Raena has been pretty neat about her eating habits so far.

Grass hay is an important part of a chinchilla's diet as it adds fiber, important for proper digestion and teeth wearing (chinchilla's teeth grow constantly through their lives so need to be monitored for problems associated with overgrowth.) Hay also just gives these little guys something to do. Bored chinchillas often start to "barber" or chew on themselves, and many become bald as Edgar almost did. Alfalfa hay has the wrong calcium/phosphorus ratio for proper chinchilla nutrition, so should be avoided. Any hay fed to them should be clean with no evidence of mold, insects, or wild rodent contamination.

I mentioned earlier that Raena loved the raisin that Michael gave her. Dried fruit and nuts are great treats for chinchillas-and these little guys really do look like they are just relishing those treats! Fresh veggies are great, too, but all these treats should only be about 10% of the total diet. Because of their original habitat, dry, barren mountainous regions, chinchillas aren't used to taking in lots of fluids like what is found in fresh produce. They will likely drink much less water if they are offered these fresh treats, but their urine output should remain about the same. Be sure to monitor this for any changes or problems. Raena has a wonderful plastic corner box which she uses as a litter box. I just take that out and rinse it out every other day or so-it really cuts down on the need for an over-all bedding change in her cage. Pretty cool, huh?

One unique part of chinchilla husbandry is the need to offer them a dust bath a couple of times a week. Raena LOVES hers! She takes her dust bath in a little plastic box, big enough for her to twist and turn and spin all around, covering herself from head to tail with the lightly colored powder. When she is done all you can see are her two little eyes peeking out of all that powdered fur. The dust is actually a finely ground volcanic ash, and it serves to keep that wondeful fur clean, oil free and over all well groomed. I think it is just plain fun for them to spin around in the bath! Here's a good You-tube video of a chinchilla enjoying his bath:
Chinchilla Dust Bath
I don't leave the bath in the main cage all the time or it gets used as a litter box...and then it isn't much good as a grooming aid.

Raena is a pretty tame chinchilla, but she still doesn't like being handled all that much. In general, chinchillas are usually easy to handle and rarely bite (although any little critter can if agitated enough.) More likely, they might just urinate when they are annoyed about being held-so watch out! You also have to be gentle when handling chinchillas due to the possibility of 'fur slip." This is a sudden shedding of the hair coat in a patchy way that occurs when it is grasped or handled roughly. I haven't ever seen this happen-and I hope I don't! Doesn't 'fur slip' sound awful? As with any animal, just be gentle but firm when holding or restraining a chinchilla to avoid injuries to you or them.

The average life span for a pet chinchilla is 8 to 10 years, but there have been reports of some reaching 18 years! Raena is 6 years old right now, so she should have a good long life ahead of her-I sure hope so! She has already brought a lot of joy to our home, and I am so very grateful to her first owners for letting us adopt her into our family. I have been playing around with how her name is spelled, and even if we should keep her name as it is since it is so darned close to my own. I found several different definitions for her name, including "queen," "pure," and "song." We'll see how things work out. For now, our "pure little song queen" is working her way into our isn't taking long to accomplish that!